A drug prescribed for type 2 diabetes, Ozempic® is increasingly diverted from its primary use and used for the purpose of weight loss in non-diabetic people. Even if according to the National Medicines Safety Agency, diversions seem limited, it nevertheless reminds that:
- Ozempic® must be prescribed only in insufficiently controlled type 2 diabetes, in accordance with its marketing authorization (AMM);
- that the diversion of this medication for weight loss has a direct impact on its availability for diabetic patients and can cause, or accentuate, supply tensions depriving them of this essential treatment;
- and that it can cause potentially serious adverse effects, such as gastrointestinal disturbances, pancreatitis or hypoglycemia.
Ozempic®: what are the indications for this medication?
Marketed since April 2019, Ozempic® is an injectable medication indicated in the treatment of type 2 diabetes. It contains semaglutidethe same active molecule as Wegovy®. “Ozempic® was developed by the Novo Nordisk laboratory solely and specifically for the treatment of type 2 diabetes and provided a real advantage compared to other GPL-1 (glucagon-like peptide-1) analogues already on the market such as Victoza® or the Trulicity®“recalls Dr Dupuy.
What is the difference with Wegovy®?
Also developed by the Danish laboratory Novo Nordisk, Wegovy® also contains semaglutide. But unlike Ozempic®, the use of which is reserved for type 2 diabetics, Wegovy® is indicated in the treatment of obesity. “It’s the same molecule as Ozempic® but the dosage goes up to 2.4 mg”, specifies the diabetologist endocrinologist. Wegovy® benefited from early access to use granted by the ANSM on July 21, 2022. “We had the opportunity to use it in a very specific context: patients had to have a body mass index (BMI) greater than 40 and present at least one comorbidity: treated dyslipidemia, treated hypertension, cardio-vascular disease. established vascular or even a sleep apnea syndrome”, adds the specialist. If since September 27, 2023, the drug no longer benefits from early access – with the exception of patients already treated – it should be authorized in France by summer 2024.
What are the effects of semaglutide on the body? How does he act?
During food intake, several gastrointestinal hormones – incretins – are secreted. Among them, glucagon-like peptide-1 (GLP-1) stimulates the secretion of insulin (hypoglycemic hormone), slows down the secretion of glucagon (hyperglycemic hormone), slows emptying of the stomach and has an effect on the satiety. “GLP-1 analogues such as semaglutide will mimic the action of GLP-1 and allow patients to have a feeling of gastric fullness more quicklyexplains Dr. Dupuy. They will therefore eat less and lose weight. The counterpart is that this molecule can have side effects at the digestive level: nausea, vomiting, slowing down of the functioning of the stomach, transit disorders…”
Ozempic® vs Wegovy®: method of administration and dosage
Both medications – Ozempic® and Wegovy® – are administered by injection once a week. “In general we increase the dosage of Ozempic® every month: after four injections at 0.25 mg, we move to 0.50 mg. The usual dose is 1 mg. As for Wegovy®, we gradually increase the level every month until we reach 2.4 mg which is the maximum dosage. This molecule was a real revolution in our therapeutic arsenal. But obesity remains a chronic disease. When you stop treatment, you gain weight again.”
What are the side effects of semaglutide?
All medications have side effects and semaglutide is no exception. “The most common side effects are gastrointestinal problems, including nausea, vomiting, diarrhea and constipationsays the Center for Obesity and Nutrition. Semaglutide may also increase the risk of pancreatitis, kidney failure, and medullary thyroid carcinoma, especially in patients with a family history of this cancer.” Finally, semaglutide can cause hypoglycemia when combined with insulin secretors.
What is the treatment for these two medications?
In France, Ozempic® is 100% covered in patients recognized as having a long-term condition (ALD) for their type 2 diabetes. “On the other hand, regarding medications against obesity, currently only Saxenda® – a specialty based on liraglutide indicated for weight control – can be prescribed and it is not reimbursed”, confides Dr. Dupuy. Hence the temptation sometimes to divert Ozempic® from its primary use for weight loss… while waiting for Wegovy®, already authorized in Europe, to be available in France.